Billing and Eligibility Professional

TASK TITLE: Billing and Eligibility Specialist

LOCATION: Auburn, CA

GENERAL STATEMENT OF DUTIES:

Under basic guidance the Billing and Eligibility Specialist is accountable for the decision of client eligibility and registration in the sliding-fee-scale, Medi-Cal and other state privilege programs. The function will carry out regular eligibility and billing functions in partnership with the outsourced earnings cycle business and under the instructions of the Revenue Cycle Coordinator to make sure the Center makes the most of 3rd party collections.

GENERAL DUTIES: (This list might not consist of all of the responsibilities appointed.) Assist clients in finishing sliding-fee-scale applications and procedure the application in accordance with Board authorized policy.

• Assist clients with eligibility decision and registration in Medi-Cal and other state privilege programs.
• Resolve any eligibility inconsistencies to guarantee client monetary info is precise.
• Assist with earnings cycle enhancement jobs as designated.
• Assist front desk receptionists, brand-new client organizers and other functional personnel by being the point of contact to respond to insurance coverage and eligibility associated concerns.
• Perform on-site confirmations each year to guarantee suitable publishing of the sliding-fee-scale signs.
• Verify money and help with front desk collections as designated.
• Process deposit gotten in the mail for publishing by the outsourced billing business.
• Assist with A/R write-off and collection jobs as designated.
• Answer billing associated telephone call. Offer outstanding and expert customer support to internal and external consumers.
• Quality Improvement Duties:
• Participates in quality enhancement activities;-LRB-
• Participates as appointed in interdepartmental quality enhancement synergy; and
• Contributes to total Community Health Center efforts in quality enhancement towards higher-quality, more cost-efficient healthcare for clients and enhanced quality of work-life for employee.
• Other responsibilities as designated.

MINIMUM EDUCATION and/or EXPERIENCE: Education: High school diploma or equivalent.

• Computer literate, e-mail, MS Office and information entry abilities needed. Capability to type 45 wpm and make use of a ten-kay calculator.

PREFERRED EDUCATION and/or EXPERIENCE: Training and experience in a FQHC setting chosen: Unless otherwise shown, one year of present experience within the last 3 years in an equivalent task category needed.

Western Sierra Medical Clinic – Auburn Sites.

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